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ARCHIVED REPORTS_XR0006361
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6633
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006361
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Entry Properties
Last modified
4/7/2020 1:05:00 PM
Creation date
4/3/2020 4:38:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006361
RECORD_ID
PR0528433
PE
2957
FACILITY_ID
FA0019174
FACILITY_NAME
CHEVRON SERVICE STATION 9-6171
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741048
CURRENT_STATUS
02
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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s 0 • 1-Plzsl2-1- 16`d 0 <br /> OC to <br /> Fax copy of Lab Report and Cy <br /> -Chain—oi-�Cus od — ecoc <br /> Chevran r'aclllly Number 9-6171 Chevron Contact: ❑ NoBRETT HUNTER <br /> Chevron Contact (Name) <br /> chevron Producla Co, <br /> Facllfly Address 6.6AIM. (Phone).33 Pacific AIM. Storlrnn (925) 842-8695 <br /> g Z �� M - �-- <br /> I.0` 80X 6004 Cansullant Project Humber I f� Laboratory Name_ SEQUOIA <br /> ;on paMo1, CA 94583 consultant Name BLAINE TECH SERVICES INC. Laboratory Service Order <br /> Address 1680 ROGERS AVE. , SAN JOSE <br /> A}{ 925}842-8370 Laboratory Service Code <br /> r Project contact (Hama) CHRISTINE LILLIE Samplas Collected by (Name) <br /> (Phdna) 408-573-0555 (Fax Number) 408-573-7771 Signature <br /> State Method: ❑ CA ❑ 0R ❑ WA ❑ NW Series ❑ CO ❑ UT Remarks <br /> f � lF � _ <br /> <u ++ Z <br /> A <br /> Lab Sample No <br /> F Uv- w o f NX <br /> �AJ <br /> nq<de ad Ig 1 a t Ilan D le/llme ^ Received By (Slgnolure) arganlzallon rbc#e`Ife g 4 load Y/N Turn Around lime (Cfrcla Chatce) <br /> t, 1 24 We <br /> ngedshed By (Signature) a►ganizallan Dole/TTii�ms. Recalved By (Signature) Or anizallon Dale/lime load Y/H 48 Hre <br /> B Days <br /> ulshed By nelura Or �e— a�rReoleved For Laboratory By (signature) a s <br /> Dals/#7me loed{]�/N As Contracts <br /> j°I <br />
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